The recommended coding pathway, using a universal safeguarding code ‘child is cause for concern’ (with additional codes where indicated), as recommended by the RCGP Multisite Safeguarding Audit team,1 has the potential to increase significantly the amount and consistency of safeguarding information recorded in primary care.
The universal code chosen would need to have a SNOMED CT®2 equivalent or an application to have this term requested from the UK Terminology Centre. The team identified one of the barriers to recording safeguarding concerns is ‘the disincentive to use permanent and potentially stigmatising codes that could be seen by patients and parents’. I would be interested to know if the team have, or plan to, conduct any research on the views of parents regarding coding and the universal term chosen. Although I would feel confident using the ‘child is cause for concern’ code where I would also code child protection plans and other significant family events such as domestic violence, I would hesitate to use this particular code for recording family risk factors where there is not a current concern about the parenting ability.
A single universal code would be ideal; if however, a suitable term could not be found to cover all situations, perhaps one term relating to actual child protection procedures and a second term to be used for recording ‘risk’ would increase recording. ‘Family with young children’ is a SNOMED CT which could be used in parents’ notes to ensure any children in the household are kept in focus when the parent is seen.
GMC advice3 states ‘You must record your concerns, including minor ones, in the child’s or young person’s records (and in their parents’ records ...’. Pertinent family information including parental risk factors can be recorded in the child’s records.4 A coding pathway would need to clarify how to record this information so that it is easily seen, but not inadvertently shared, for example in a referral letter which has imported the child’s problem list. An IT solution could be developed to avoid any risk of accidental disclosure and remove this potential barrier to recording.
- © British Journal of General Practice 2012
